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Redesigning Clinical Care with Analytics
Session #142, February 13, 2019
Paul J. Lampi
Director, Enterprise Analytics and Reporting
Memorial Hermann
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• Memorial Hermann Intro
• Clinical Care Redesign Overview
• Healthcare Analytics Strategy
• Developing Analytics Solutions
• Benefits and Impact
• Looking to the Future
Agenda
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• Deliver high quality care thru clinical care re-design
• Reduce waste and operational inefficiencies to drive measurable
savings
• Deploy actionable insights from analytics to drive a ‘data driven
culture’
Learning Objectives
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• Memorial Hermann Intro
• Clinical Care Redesign Overview
• Healthcare Analytics Strategy
• Developing Analytics Solutions
• Benefits and Impact
• Looking to the Future
Agenda
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MHHS by the Numbers
$6.0B Total Assets
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$5.3B Net Operating Revenue
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24,000 Employees; 5,000 Physicians
Greater Houston MSA 6.6 million population, projected to 7.1 million (2020)
• 16 Hospitals
• 267 Care Delivery Sites
• 3,800+ Licensed Beds
• 844k+ Inpatient Days
• 154k+ Inpatient Admissions
• 1.2M Diagnostic & Therapeutic Visits
• 550k+ Annual Emergency Visits
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• Memorial Hermann Intro
• Clinical Care Redesign Overview
• Healthcare Analytics Strategy
• Developing Analytics Solutions
• Benefits and Impact
• Looking to the Future
Agenda
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• Why did we need to implement this strategy?
• Increasing Costs
• Inefficient and Inconsistent Processes
• Waste
• Supply Chain
• Decreasing Revenue
• Regulations
• Insurance Reductions
• Recipe for Disaster
Clinical Care Redesign Challenges
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Clinical Care Redesign Focus
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How to Achieve Our Goal
• Data!!!
• Needs
Wide dissemination of data
Various levels of detail
Utilization of MANY different data sources
Ease of interpretation
Users with varying roles and responsibilities
Ability to see high level and drill down to detail
One stop shop
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• Memorial Hermann Intro
• Clinical Care Redesign Overview
• Healthcare Analytics Strategy
• Developing Analytics Solutions
• Benefits and Impact
• Looking to the Future
Agenda
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• Self-service
– Data Power to the People
– Tools to educate and empower
– Teach to fish…100+ dashboard creators
• Right data at the Right time for the Right role
• Spend time telling and interpreting the
story…NOT putting it together
• Data Warehouse…one source of truth
Healthcare Analytics Strategy
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Paid Claims
On-site Biometrics
EMRs
SmartData EDW
Applications AnalyticsAlgorithms
• Sepsis
• TOC
• Readmissions
• HCC Suspected
• 3M
• Truven
Consumer
Healthcare Analytics Strategy
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• Memorial Hermann Intro
• Clinical Care Redesign Overview
• Healthcare Analytics Strategy
• Developing Analytics Solutions
• Benefits and Impact
• Looking to the Future
Agenda
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Care Redesign Solution Lifecycle
• Waste
Identification
• Key Drivers
• Solutions
• Metrics
• Key Indicators
• Actionable
Metrics
• Performance
Improvement
• Financial
Impact
• Budget
Comparison
• Realized
Savings
• Next
Opportunity
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Opportunity Exploration
• Balanced scorecard to find
improvement opportunities
• Compare:
• ALOS
• Cost per Case
• Readmissions
• Patient Satisfaction
IMPACT
Identified opportunities
based on benchmarks
to save $200M in Care
Variation
Opportunity by ALOS, Cost, Mortality and Readmissions
**Sample Data Only – Visualizations provided for concept and format purposes only.
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Ortho Monitoring
**Sample Data Only – Visualizations provided for concept and format purposes only.
IMPACT
Orthopedic Joints: reduced
average LOS from 2.39 to
2.25 days
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Ortho Monitoring
**Sample Data Only – Visualizations provided for concept and format purposes only.
IMPACT
Joints: reduced
utilization of Bone
Cement with
Antibiotic for
elective primary
cases from 46%
to 27%
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Medical Power Plan (MPP) Utilization
**Sample Data Only – Visualizations provided for concept and format purposes only.
IMPACT
Net increase of 2%
overall execution of
Medical Power Plans
with many increasing
~4-10% in 7 months
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Sepsis Monitoring – Roll-up
**Sample Data Only – Visualizations provided for concept and format purposes only.
IMPACTS
Reduced Sepsis ALOS
across the System from
5.74 to 5.64 days
Decreased mortality from
9.4% to 8.6%
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Sepsis Monitoring – Patient Level
**Sample Data Only – Visualizations provided for concept and format purposes only.
Patient level view of ED to
Unit timeline with various
treatment milestones in a
visualization to identify
areas for improvement.
IMPACT
Detailed view of patient
details in support of
Sepsis Care Pathway
for actionable insights
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CABG* Monitoring
*CABG = Coronary Artery Bypass Graft
Outliers
Targets
**Sample Data Only – Visualizations provided for concept and format purposes only.
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CABG* Monitoring
*CABG = Coronary Artery Bypass Graft
Outliers
**Sample Data Only – Visualizations provided for concept and format purposes only.
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CABG* Monitoring
IMPACT
Detailed view of
patient details in
support of CABG
milestones in Care
Pathway for
actionable insights
*CABG = Coronary Artery Bypass Graft
**Sample Data Only – Visualizations provided for concept and format purposes only.
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Trach/Vent* Monitoring
IMPACT
Southwest Clinical
Pathway Pilot study
reduced ALOS from 34.7 to
28.0 days
Southwest ICU reduced
ALOS from 26.5 to 15.2
*Trach/Vent = Tracheostomy and Ventilator
**Sample Data Only – Visualizations provided for concept and format purposes only.
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Women’s LOS Monitoring
**Sample Data Only – Visualizations provided for concept and format purposes only.
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Women’s LOS Monitoring
IMPACTS
Reduced ALOS
from 4.6 to 2.7
days
$479,965 FY18
annualized
savings
**Sample Data Only – Visualizations provided for concept and format purposes only.
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Benefit Model/Cost Comparison Overview
**Sample Data Only – Visualizations provided for concept and format purposes only.
Workstreams
Facilities
Key focus area
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Mean Summary by APR DRG
Drill Down
to Details
**Sample Data Only – Visualizations provided for concept and format purposes only.
Benefit Model/Cost Comparison Overview
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• Memorial Hermann Intro
• Clinical Care Redesign Overview
• Healthcare Analytics Strategy
• Developing Analytics Solutions
• Benefits and Impact
• Looking to the Future
Agenda
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Benefits and Impact
Culture change
at EVERY Level
Data-driven
Decision Making
Tell the Story
and Change It!
New way of life!
FY18 Budget Savings: $40M
FY18 Savings Achieved: $44M
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• Memorial Hermann Intro
• Clinical Care Redesign Overview
• Healthcare Analytics Strategy
• Developing Analytics Solutions
• Benefits and Impact
• Looking to the Future
Agenda
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Lessons Learned
• Don’t boil the ocean…crawl, walk, run
• Don’t let PERFECT be the enemy of GOOD
• Agile development
• Definitions/Data Governance
• Only as good as data you have…never too
early to start
• It takes a village…education to “Think Data
and actionable insights”
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Roadmap for the Future
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Paul J. Lampi
Director, Enterprise Analytics and Reporting
Memorial Hermann
Paul.Lampi@memorialhermann.org
Questions
